Overview
Scope of Responsibilities: Provide guidance, assistance and expertise regarding specialty assistance programs between ProAct and contract pharmacies to include Noble Health Services and other specialty and/or retail pharmacies. Coordinate with all appropriate parties to secure funding assistance, medication shipment and regularly communicate updates on member-specific cases. Works under direct supervision and follows standard procedures to accomplish assigned tasks.
Job Summary: Responsible for coordinating functions related to specialty assistance programs to include, but not limited to ProActPLUS and other external copay sourcing program related operations on a day-to-day basis. Act as the liaison between ProAct, and Noble Health Services (or other network pharmacies) to support these programs and its components.
Responsibilities
Job Duties:
- Support ProAct clients and members regarding functions related to specialty assistance programs.
- Partner with Noble Health Services and other network pharmacies on the administration of ProAct-owned programs such as ProActPLUS as well as third party solutions and other utilization management programs.
- Perform outreach to physician offices and members to request prescriptions, confirm assistance components, etc.
- Process overrides in ProAct’s processing database to ensure claims are processing as intended after funding is secured.
- Assist Noble and other network pharmacies with various other ProAct-related inquiries or overrides that need to be entered for successful claim processing.
- Complete all mandatory KPH, state, and federal training programs.
- Perform other duties as assigned.
Qualifications
Experience Preferred:
- Preferred: 2 Years experience with Health Care, Insurance and/or Project Management
Special Conditions of Employment:
- Drug test
- Initial and continuous exclusion and sanction/disciplinary monitoring
- Any and all additional eligibility requirements based on the specific position
Required Training:
- HIPPA Privacy Course and CE Mastery Exam
- HIPPA Security Course and CE Mastery Exam
Job Requirements:
- Successful completion of a pre-employment and/or random drug screening test
Job Skills Required:
- Strong Communication Skills, must be able to effectively communicate both on the phone and in email setting
- Strong PC Skills, will be using multiple different PC programs
- Must be able to work independently
Behavioral Traits Required:
- Customer Service: Must provide timely and accurate responses to all business associates and customers
- Organization: Must organize work in a systematic way, establish clear lines of responsibility, and delegate effectively
- Communication: Must write and speak clearly and effectively at all levels, listen and be attentive to others
- Technology: Must use technology to its fullest potential to achieve department and corporate goals
- Flexibility: Ability to adapt to changing business needs. To balance multiple priorities and deliver under pressure
